摘要
目的：总结超声诊断12例双调转术治疗矫正型大动脉转位的体会。材料与方法：12例中，大动脉转位SLL型11例，IDD 1例。手术方式：心房内调转1例，11例用改良sinning手术，即切开左房、房间隔将上、下腔静脉与解剖右心室、三尖瓣相通，用自体心包片将肺静脉与解剖左心室及二尖瓣相连；10例合并VSD与PS患者用心内修复采用人工血管在VSD与主动脉之间建立隧道，经解剖右心室到肺动脉用人工心外管道，2例肺动脉瓣正常患者经解剖右心室修补VSD，然后行主动脉、肺动脉两个大动脉调转术。使用日本东芝6000型，美国菲利浦IE33型彩色多普勒超声诊断仪，探头频率2.5～3.75MHz。术前用体表超声（TTE）明确诊断，术后随诊用TTE。结果：12例C-TGA TTE准确诊断，超声诊断与心血管造影及手术符合率100%。12例C-TGA行双调转术，9例手术成功，3例死亡。术后用TTE随诊。9例中8例VSD补片完善，1例残余漏。9例存活双调转术患者，术前、后均用TTE监测左心室及右心室心功能正常。9例右心室到肺动脉心外管道血流正常。结论：超声诊断C-TGA及合并畸形及术前帮助选择适合行双调转术的病例，术后用TTE随诊手术效果有一定的临床价值。
Abstract
Objective: Summarize the experience of echocardiographic diagnosis on 12 patients with C-TGA underwent double switch procedure. Materials and Methods: Twelve C-TGA patients, 11 were attributed to SLL type, one was IDD type. Surgical procedure included that atrial switch was performed in 1 patients. Modified sinning procedure was performed in 11 patients, which involved opening of left atrium, atrial septum, connecting both superior vena cava and inferior vena cava into pathological right ventricle and tricuspid valve, meanwhile connecting pulmonary veins and pathological left ventricle and bicuspid with pericardium respectively. There were 10 patients with VSD and PS surgically performed by establishing a tunnel between VSD and aorta by Dacro Vessel and by putting extra-conduit between pathological right ventricle and pulmonary artery. Last two cases with normal pulmonary valve were corrected by patching VSD and switching between aorta and pulmonary artery. Instrument routinely used in the study is Toshiba 6000 and Philips IE33 with probe frequency ranging from 2.5 to 3.75MHz. Results: All patients were correctly diagnosed as C-TGA by TTE. Echocardiography and angiocardiography all were consistent with surgical finding. Of the 12 patients corrected by double switch, 9 patients survived and others died. During follow-up with TTE, all of the 9 patients were in normal right and left ventricular function, conduits from right to pulmonary were in normal state, except 1 patient had a residue VSD. Conclusions: Echocardiography plays an important role in diagnosing C-TGA with heart malformation and also helps to confirm indication for double switch, and TTE has clinical significance in following up of surgical procedure as well.
关键词
心脏缺损 /
先天性 /
超声心动描记术 /
多普勒 /
彩色
Key words
heart defects /
congenital /
echocardiography /
Doppler /
color
邓东安;侯传举;朱鲜阳;朱洪玉;汪曾炜.
超声对双调转术治疗矫正型大动脉转位合并心内畸形的临床研究[J]. 中国临床医学影像杂志. 2007, 18(1): 19-21
DENG Dong-an;HOU Chuan-ju;ZHU Xian-yang;ZHU Hong-yu;WANG Zeng-wei.
Clinical study of echocardiography on C-TGA complicated with heart malformation underwent double switch procedure[J]. Journal of China Clinic Medical Imaging. 2007, 18(1): 19-21
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